Abstract
We report a case of concomitant injury to the aortic valve and internal mammary artery (IMA) from nonpenetrating chest trauma. To our knowledge, this is the first such case to be reported. Transcatheter arterial embolization (TAE) following diagnostic angiography offers an effective and minimally invasive treatment for traumatic IMA injuries. Because there might be an asymptomatic interval after traumatic aortic valve injuries, serial physical examinations and repeated echocardiography should be mandatory for patients with de novo heart failure after blunt chest trauma. Transesophageal echocardiography can provide a clearer image of cardiac injuries than transthoracic echocardiography, particularly if there is extensive anterior mediastinal hematoma resulting from IMA trauma.
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Irgau I, Fulda GJ, Hailstone D, Tinkoff GH. Internal mammary artery injury, anterior mediastinal hematoma, and cardiac compromise after blunt chest trauma. J Trauma 1995;39:1018–1021.
Kawamura S, Nishimaki H, Takigawa M, Lin ZB, Imai H, Hayakawa K, et al. Internal mammary artery injury after blunt chest trauma treated with transcatheter arterial embolization. J Trauma 2006;61:1536–1539.
Parry GW, Wilkinson GA. Traumatic aortic regurgitation. Injury 1997;28:679–680.
Parmley LF, Manion WC, Mattingly TW. Nonpenetrating traumatic injury of the heart. Circulation 1958;18:371–396.
Haskins CD, Shapira N, Rahman E, Serra AJ, McNicholas KW, Lemole GM. Repair of traumatic rupture of the aortic valve. Arch Surg 1992;127:231–232.
Chen MY, Regan JD, D’Amore MJ, Routh WD, Meredith JW, Dyer RB. Role of angiography in the detection of aortic branch vessel injury after blunt thoracic trauma. J Trauma 2001;51:1166–1171; discussion 1172.
Demetriades D, Gomez H, Velmahos GC, Asensio JA, Murray J, Cornwell EE 3rd, et al. Routine helical computed tomographic evaluation of the mediastinum in high-risk blunt trauma patients. Arch Surg 1998;133:1084–1088.
Braatz T, Mirvis SE, Killeen K, Lightman NI. CT diagnosis of internal mammary artery injury caused by blunt trauma. Clin Radiol 2001;56:120–123.
Whigham CJ Jr, Fisher RG, Goodman CJ, Dodds CA, Trinh CC. Traumatic injury of the internal mammary artery: embolization versus surgical and nonoperative management. Emerg Radiol 2002;9:201–207.
Weiss RL, Brier JA, O’Connor W, Ross S, Brathwaite CM. The usefulness of transesophageal echocardiography in diagnosing cardiac contusions. Chest 1996;109:73–77.
Nascimento J, Lemos C, Marques AM, Antunes MJ, Gonsalves A. Traumatic aortic valve insufficiency (in Portuguese with English abstract). Rev Port Cardiol 1996;15:147–152, 101.
Gay JA, Gottdiener JS, Gomes MN, Patterson RH, Fletcher RD. Echocardiographic features of traumatic disruption of the aortic valve. Chest 1983;83:150–151.
Crosby IK, Muller WH Jr. Acquired disease of the aortic valve. In: Sabiston DC Jr, Spencer FC, editors. Gibbon’s surgery of the chest. Philadelphia: Saunders; 1983. p. 1280–1305.
Obadia JF, Tatou E, David M. Aortic valve regurgitation caused by blunt chest injury. Br Heart J 1995;74:545–547.
Munshi IA, Barie PS, Hawes AS, Lang SJ, Fischer E. Diagnosis and management of acute aortic valvular disruption secondary to rapid-deceleration trauma. J Trauma 1996;41:1047–1050.
Kawazoe K, Izumoto H, Satoh Y, Eishi K, Ishibashi K. Annuloaortic repair in the treatment of aortic regurgitation and aortic root pathology. Surg Today 2001;31:27–31.
Pretre R, Faidutti B. Surgical management of aortic valve injury after nonpenetrating trauma. Ann Thorac Surg 1993;56:1426–1431.
Meunier JP, Berkane N, Lopez S, Sicart-Toulouse C, Malzac B, Isetta C, et al. Traumatic aortic regurgitation: diagnostic, management and treatment (in French with English abstract). Arch Mal Coeur Vaiss 2004;97:613–618.
Devineni R, McKenzie FN. Avulsion of a normal aortic valve cusp due to blunt chest injury. J Trauma 1984;24:910–912.
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Yeh, CC., Hsieh, CH., Wang, YC. et al. Concomitant aortic valve and internal mammary artery injuries in blunt chest trauma: Report of a case. Surg Today 39, 790–794 (2009). https://doi.org/10.1007/s00595-008-3915-3
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DOI: https://doi.org/10.1007/s00595-008-3915-3